Benign Disease Group Research Articles

Evaluation of Urine Tumor-Associated Trypsin Inhibitor, CYFRA 21-1, and Urinary Bladder Cancer Antigen for Detection of High-Grade Bladder Carcinoma

To assess the value of urine tumor-associated trypsin inhibitor (TATI), CYFRA 21-1, which measures cytokeratin 19 fragment, and urinary bladder carcinoma antigen (UBC) for the detection of high-grade bladder carcinoma. A total of 160 individuals were enrolled in the present study. Of these, 80 were patients with proven primary high-grade urothelial bladder cancer (group 1), 40 were healthy volunteers (group 2), and 40 had history of benign urologic disease (group 3). All were evaluated with respect to urinary TATI, CYFRA 21-1, and UBC levels. All these markers were evaluated using commercial kits. Cytology was also performed. The TATI measurements were significant greater in group 1 compared with groups 2 and 3. The cutoff point used for TATI, CYFRA 21-1, and UBC was 22, 2.8, and 12 microg/L, respectively. The overall sensitivity was 85.7% for TATI, 61.9% for CYFRA 21-1, 50% for UBC, and 42.8% for cytology. TATI was significantly more sensitive in Stage Ta (80%) than was CYFRA 21-1 (32%), UBC (12%), and cytology (20%). TATI was also more sensitive compared with other tumor markers for Stage T1 but not for Stage T2 or T3. The results of our study have shown that TATI is a promising urinary tumor marker for high-grade urothelial bladder cancer. It is more sensitive than CYFRA 21-1, UBC, and cytology for Stage Ta and T1 bladder cancer.

Biopsy of cervical lymph node

Objective This report examines 60 non-cancer patients who underwent a cervical lymph node biopsy, and discusses the value of the cervical lymph node biopsy as a diagnostic tool. Methods Sixty patients with cervical lymph node enlargement who had lymph node biopsies at the Juntendo University between 2004 and 2007 were examined. The clinical parameters including age, size of the lymph node, white blood cell (WBC), C reactive protein (CRP), lactate dehydrase (LDH), soluble interleukin-2 receptor (sIL-2r) were measured at initial examination. Fine needle aspiration cytology was carried out in all patients. The patients were divided into 2 groups, including the malignant lymphoma (ML) group and the benign disease group. These groups were compared based on the patient's clinical parameters. Results Serum levels of LDH, sIL-2r, age and lymph node size in the ML group were significantly higher than in the benign group. WBC and CRP showed no significant differences. Simple regression analysis showed that there are correlation between the size of enlargement lymph node and serum levels of LDH and sIL-2r in ML group. Conclusion The results of this study suggest that a biopsy should be considered early to patients with an advanced age, large swollen lymph nodes or high levels of serum sIL-2r or LDH.

Liver Transplantation at a Small-volume Procedure Center—Preliminary Results from Taipei Veterans General Hospital

Liver transplantation is a challenging procedure that is associated with perioperative morbidity and mortality, so it is justifiable to perform such a procedure in high-volume procedure centers. Organ shortage remains a major issue in Taiwan. Due to the difficulty in establishing a high-volume procedure center, it is important to review the overall outcome of patients undergoing liver transplantation at a small-volume procedure center to determine if performing such a procedure is justified. Between April 2001 and May 2005, 26 adults underwent deceased donor liver transplantation at Taipei Veterans General Hospital. The overall outcomes were reviewed in terms of 90-day mortality, 1-year and 3-year survival rates. In addition, the patients were divided into a hepatocellular carcinoma (HCC) group (n = 12) and a benign end-stage liver disease (ESLD) group (n = 14). The clinical demographics, 90-day mortality, 1-year and 3-year survival rates were reviewed and compared between the 2 groups. The 90-day mortality was 15.3% in the whole series, 8.3% in the HCC group and 18.7% in the ESLD group. The overall 1-year and 3-year survival rates were 76.9% and 63.5%, respectively, for the whole series. For the 2 groups, the respective 1-year and 3-year survival rates were 83.3% and 71.4% in the HCC group, and 71.4% and 57.1% in the ESLD group. The survival difference was not significant (p = 0.319) between the 2 groups. In the HCC group, the 1-year and 3-year disease-free survival rates were 88.9% and 71.1%, respectively. The survival rates between ESLD and HCC patients undergoing liver transplantation at a small-volume procedure center were comparable. The results of the whole series were not satisfactory, but the results for the HCC group were acceptable.

Clinical significance of the circulating tumor-associated antigen CA 19-9 in cancers of the digestive tract

The relevance of the tumour associated antigen CA 19-9, defined by a monoclonal antibody, was investigated in 471 patients with carcinomas of the gastrointestinal tract and in 100 patients with benign diseases of the abdomen. In the early stages of gastric and colorectal carcinomas the sensitivity of the CA 19-9 test was between 10 and 25% and increased to about 50% in tumour stage IV. Detection rate in pancreatic carcinoma was 88% and thus markedly higher. The specificity of the test, as against the group of benign abdominal diseases, was 95%. Postoperative CA 19-9 follow-up showed unaltered individual baseline values in 192 out of 196 cases without clinical evidence of tumour progression. However, in 40 out of 61 cases (66%) with recurrencies or metastases continuous increases of CA 19-9 were observed which preceded the clinical relapse by up to 16 months (median 2 months). Concomitant determination of CEA increased sensitivity to 90% due to partial complementary information. This was particularly pronounced in gastric carcinomas in whom continuous increases of CEA involved only 58% of all patients with tumour progression. By simultaneous determination of both tumour markers this ratio rose by increases of both or one antigen to 83%.

Peripheral Zone Hypoechoic Lesions of the Prostate

The purpose of this study was to evaluate the efficacy of contrast-enhanced gray scale transrectal ultrasonography (TRUS) for detection of prostate cancer in peripheral zone hypoechoic lesions of the prostate. The study involved 66 patients with peripheral zone hypoechoic lesions detected by TRUS. The lesions were evaluated with contrast-enhanced TRUS to differentiate prostate cancer from benign lesions, and the results were compared with color Doppler ultrasonographic findings. Transrectal ultrasonographically guided biopsy of the hypoechoic lesions revealed prostate cancer in 30 patients and benign prostatic diseases in 36. Flow signals within the lesions were classified as no, increased, equal, and decreased flow compared with surrounding peripheral zone tissue as follows: 1, 16, 12, and 1, respectively, in the prostate cancer group and 10, 12, 10, and 4 in the benign disease group. If we considered an increased flow signal within a peripheral hypoechoic lesion as a sign of prostate cancer, color Doppler ultrasonography had low sensitivity and specificity (55.2% and 53.8%, respectively). The enhancement intensity within the lesions was classified as no, increased, equal, and decreased enhancement compared with surrounding peripheral zone tissue as follows: 2, 20, 3, and 5 in the prostate cancer group and 14, 8, 4, and 10 in the benign disease group. The difference was statistically significant (P<.05). Thus, the peak enhancement intensity would be the optimal parameter for discriminatory performance (area under the receiver operating characteristic curve, 0.74; 95% confidence interval, 0.60-0.88). Contrast-enhanced TRUS could reveal the presence of vasculature within peripheral zone hypoechoic lesions more objectively than color Doppler ultrasonography and could be promising in guidance of prostate biopsy.

Concluding remarks

Concluding remarks

Significance of mesenteric lymphadenopathy after pancreaticoduodenectomy for periampullary carcinomas: Evaluation with serial MDCT studies

Objective To evaluate the significance of mesenteric lymphadenopathy arising after pancreaticoduodenectomy (PD) for periampullary carcinomas. Materials and methods Serial multidetector CT (MDCT) studies in 44 patients after PD for periampullary carcinomas (Group A) were retrospectively reviewed, the incidence and interval changes of mesenteric lymphadenopathy were evaluated, and comparisons were made with 21 patients who underwent PD for benign diseases (Group B). Results In Group A, mesenteric lymphadenopathy was seen in 31 of 44 (70.5%) patients. The short axis diameter of the largest lymph node ranged from 6.2 to 11.5 mm (mean ± S.D.: 8.6 ± 1.4 mm), and the short-axis-to-long-axis (S/L) ratio ranged from 0.46 to 0.99 (mean ± S.D.: 0.69 ± 0.12). Six of the 31 (19.4%) mesenteric lymphadenopathy cases showed interval increases in size on follow-up studies, and three cases showed new development of mesenteric lymphadenopathy: all of these nine cases had concurrent recurrence in the mesenteric root. In Group B, 11 (52.4%) had mesenteric lymphadenopathy. The short axis diameter of the largest lymph node ranged from 5.6 to 10.9 mm (mean ± S.D.: 8.0 ± 1.9 mm) and the S/L ratio ranged from 0.48 to 0.93 (mean ± S.D.: 0.67 ± 0.12). Differences in the incidence, short axis diameter and S/L ratio were not significant between Groups A and B ( p = 0.154, 0.271 and 0.654, respectively). Conclusion Mesenetric lymphadenopathy after PD less likely reflects recurrence. Lymph node metastasis may be suggested only when coexisting recurrent mass is found in the proximal mesenteric root.

Evaluation of factors that may be responsible for cyclic change of CA125 levels during menstrual cycle

To evaluate the factors responsible for fluctuation of CA125 levels during menstrual cycle The study was performed with patients who had undergone hysterectomy for benign gynecological disease (group I, n = 30) and patients who had undergone laparoscopy for tubal ligation (group II, n = 30) or for investigation of pelvic cause of infertility (group III, n = 24) and showed normal laparoscopic findings. In groups II and III, blood samplings for serum CA125 determination were performed in menstrual and no-menstrual period. In group I, sampling times were determined by using estrogen and progesterone levels. Mean serum CA125 concentrations were compared using one-way analysis of variance (ANOVA) for multiple group comparisons and paired t test for within-group comparisons. Intra-individual serum CA125 concentrations of group I was not significantly different (P > 0.05). In group II, mean menstrual CA125 concentration was on average 18.2% higher than that of non-menstrual concentration (P < 0.001). Group III showed a similar pattern to that of group II, with a difference of 22% (P < 0.001). Mean CA125 concentration of group I in both menstrual and non-menstrual period was lower than those of groups II and III (P < 0.001). However, there was no significant difference between groups II and III when compared with the corresponding menstrual and non-menstrual CA125 concentrations (P > 0.05). Endometrium is responsible for the cyclic changes in serum CA125 concentration during menstrual cycle.

Elevation of serum l-lactate dehydrogenase B correlated with the clinical stage of lung cancer

To identify potential biomarkers related with lung cancer metastasis, conditional media (CM) proteins collected from a primary non-small cell lung cancer (NSCLC) cell line NCI-H226 and its brain metastatic subline H226Br were analyzed by one-dimensional electrophoresis (1-D PAGE) and matrix-assisted laser desorption/time of flight mass spectrometry (MALDI-TOF-MS). Twelve biomarkers were identified, of which l-lactate dehydrogenase B (LDHB) chain was significantly up-regulated in the CM of H226Br cell and was further validated in 105 lung cancer, 93 non-lung cancer, 41 benign lung disease, as well as 65 healthy individuals sera using enzyme-linked immunosorbent assay (ELISA). It was found that the levels of LDHB were specifically elevated in NSCLC sera compared with other groups and were progressively increased with the clinical stage. At the cutoff point 0.260 (OD value) on the receiver operating characteristic (ROC) curve, LDHB could comparatively discriminate lung cancer from benign lung disease and healthy control groups with sensitivity 81%, specificity 70% and total accuracy 76%. These findings demonstrated that secretome could open up a possibility to find, identify, and characterize novel biomarkers related with invasion and metastasis.

Evaluation of a novel MUC1 biomarker/target antigen for pancreatic cancer

4096 Background: Pancreatic cancer provides a major challenge in terms of diagnosis and treatment. We have developed an anti-MUC1 MAb, PAM4, which identifies an epitope that is more restricted to MUC1-expressed by pancreatic cancer than MUC1 from other forms of cancer. PAM4 has been studied for in vitro and in vivo detection and therapy of pancreatic cancer. Methods: The in vitro immunoassay consists of PAM4 as the capture reagent and an IgG fraction derived from a polyclonal, anti-MUC1 antiserum as the probe. For in vivo detection and therapy, PAM4 is either directly radiolabeled or used in a 2-step pretargeting protocol. Results: The PAM4-based immunoassay provided high sensitivity (77%) and specificity (95%), with a value ≥ 10.2 units/ml indicating a high likelihood of pancreatic cancer, as compared to normal and benign disease groups and non-pancreatic cancers. A direct pairwise comparison of the PAM4 and CA19–9 immunoassays for discrimination of pancreatic cancer and pancreatitis demonstrated a superior performance of the PAM4-immunoassay (P&lt;0.003). Initial clinical studies with directly labeled 131I-PAM4 provided positive imaging in 8/10 patients, with one negative patient having only pancreatitis, and the other negative patient having a tumor that was MUC1-negative. A Phase I, dose-escalation study of 90Y-humanized PAM4 administered as a single dose to patients with advanced pancreatic cancer is in progress (Immunomedics, Inc), and has already achieved doses of 20 mCi/m2. Finally, pretargeting involving a bispecific MAb with one arm being PAM4 targeting MUC1 and the other arm capturing a hapten peptide carrying a radionuclide is under preclinical evaluation. This second generation targeting system has shown higher tumor/nontumor ratios and improved imaging (111In) as compared to directly radiolabeled PAM4. Conclusions: These results suggest that the PAM4-reactive MUC1 epitope may prove useful as a selective biomarker/target antigen for diagnosis, detection, imaging, and therapy of pancreatic cancer. (Supported in part by grants CA96924and CA98488 from the NIH). [Table: see text]

Perspektiven der Strahlentherapie gutartiger Erkrankungen

Purpose: The numbers of patients with nonmalignant diseases referred for radiation therapy had to be evaluated for the last 4 years. Patients and Methods: In the years 2002, 2004, and 2005 radiation therapy was performed in 61, 40, and 26 patients, respectively. Regularly, more women than men were treated, median age annually was 57, 54, and 55 years, respectively (Table 1). The radiotherapy scheme was not modified within the evaluated period. Results: The proportion of nonmalignant diseases among all patients treated decreased from 4.7% in 2002 to 3.3% in 2004 and 2.2% in 2005, respectively. A shift was noticed toward the treatment of four main diseases (endocrine orbitopathy, prevention of heterotopic ossification, meningeoma, tendinitis, Table 2). The number of referring physicians decreased from 19 to six. Conclusion: Due to administrative restrictions for treatment in hospitals, budget restrictions in private practices and lasting, insufficient revenues for radiotherapy in nonmalignant diseases, radiation therapy for the entire group of benign diseases is endangered.

Prospective Comparison of Laparoscopic Left Hemicolectomy for Colon Cancer with Laparoscopic Left Hemicolectomy for Benign Colorectal Disease

Short-term outcome and anorectal function results after laparoscopic hemicolectomy for colon cancer were compared with results after laparoscopic hemicolectomy for benign diseases. A total of 108 patients who underwent laparoscopic left colectomy (60 for colon cancer, 48 for diverticulitis or polyposis) were enrolled in the study. Left hemicolectomy in patients affected by cancer was performed by high ligation of the inferior mesenteric artery. A questionnaire concerning anorectal function was mailed to patients 6 months after surgery. Complications were more frequent in the cancer group than in the benign disease group: overall morbidity rate (29.6% versus 8.7%; P = 0.009), diarrhea during the first 6 postoperative months (58.7% versus 34.1%; P = 0.022), and anorectal function problems (fecal incontinence and/or the inability to discriminate between gas and stool, and/or urgency, and/or tenesmus) (65.2% versus 31.7%; P = 0.002). The level of ligation of the lower mesenteric artery and damage at the lower mesenteric ganglion could explain the poorer anorectal function outcome in the colon cancer group.

Surgery in tropical pancreatitis: analysis of risk factors.

Over a 7-year period, 91 patients with tropical pancreatitis underwent operation for intractable pain. Univariate and multivariate analyses were performed to identify factors correlating with mortality, major complications, poor pain relief and associated malignancy. Patients with benign disease (group 1, n = 72) had longer survival than those with superimposed malignancy (group 2, n = 19). Pain relief was better in group 1 (59 patients compared with none, P less than 0.01). Age above 40 years, short duration of symptoms, mass lesions on ultrasonography and main pancreatic duct obstruction on endoscopic retrograde pancreatography were associated with a high risk of cancer. After reoperation major complications (four of ten) or death (three of ten) occurred more commonly than after primary procedures (seven of 81, P = 0.019 and five of 81, P less than 0.05, respectively). Poor pain relief in group 1 patients was more common after incomplete clearance of main duct stones (four of 13 versus three of 53, P less than 0.01) and after short length ductotomy (three of eight versus four of 58, P less than 0.01). Tropical pancreatitis has a high association with pancreatic adenocarcinoma. Wide ductotomy, stone clearance and drainage gave good symptomatic results in patients with benign disease. Overall results were poor in patients with cancer.

Comparison of TPS, CEA, CYFRA21-1 and STNFR in diagnosis of lung cancer

In recent years, new progress has been made in research of tumor markers. And namely tissue polypeptide specific antigen (TPS), cytokeratin 19-fragments (CYFRA21-1) and soluble tumor necrosis factor receptor (STNFR) are new tumor markers that have been used in clinical application. The aim of this study is to determine and compare the diagnostic value of 4 kinds of tumor markers, TPS, carcinoembryonic antigen (CEA), CYFRA21-1 and STNFR in patients with lung cancer. The serum levels of TPS, CEA, CYFRA21-1 and STNFR were determined in 72 patients with lung cancer, 54 patients with pulmonary benign diseases and 32 healthy adults by enzyme-linked immunosorbent assay (ELISA). The levels of the four tumor markers in lung cancer group were significantly higher than those in benign disease group (P < 0.005) and healthy control group (P < 0.001). Among the four markers, STNFR had the highest sensitivity (81.9%), CYFRA21-1 had the highest specificity (91.5%) and TPS had the highest accuracy (83.5%). TPS, CYFRA21-1 and STNFR can be used as very useful and sensitive tumor markers in the diagnosis of lung cancer, in which CYFRA21-1 may be the most useful tumor marker for clinical application.

Application of the Detection of CK-19 and Other Assiociated Laboratory Items in the Diagnosis of Non-small Cell Lung Cancer

目的 研究胸水和血清细胞角蛋白片段19(CK-19)等指标在非小细胞性肺癌(NSCLC)实验室诊断中的应用价值.方法采用ELISA法检测45例NSCLC、50例良性肺疾病患者血清和胸水中CK-19水平,30例健康体检者血清CK-19水平,同步测定了乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)、C反应蛋白(CRP)、癌胚抗原(CEA)、免疫球蛋白E(IgE)水平,进行显著性检验及相关性分析.结果 NSCLC组血清和胸水中CK-19、CEA和LDH水平均明显高于良性肺疾病组(p<0.05),而血清ADA水平均低于良性肺疾病组和健康对照组(p<0.05).良性肺疾病组血清和胸水CRP水平明显高于NSCLC组(p<0.05).胸水中CK-19水平与血清CK-19水平高度相关(NSCLC组r=0.868;良性肺疾病组r=0.5462).胸水和血清CK-19对肺癌的诊断敏感性、特异性和准确性分别为93.3%和71.1%、91.7%和87.5%、92%和81.6%.结论胸水和血清CK-19检测对NSCLC的诊断是一个较好的指标,联合检测相关指标有助于临床诊断。

Detection of telomerase activity in bronchial lavage as an adjunct to cytological diagnosis in lung cancer.

Definitive diagnosis of lung cancer with conventional methods may sometimes be difficult in clinical practice. Telomerase is a ribonucleoprotein DNA polymerase that maintains the telomeric region of chromosomes during successive rounds of cell division. Telomerase activity in body cavity fluids has been advocated to be a potential diagnostic marker for malignancy. We investigated the diagnostic value of telomerase activity in bronchial lavage samples of patients undergoing diagnosis of lung cancer. A total of 29 bronchial lavage samples were collected from patients in whom the diagnosis was confirmed with cytological and/or histological examinations. Patients were classified as lung cancer patients (Group 1, n = 22) and patients with benign disease (Group 2, n = 7). Telomerase activity was determined with polymerase chain reaction-based TRAP (The telomeric repeat amplification protocol) assay. Cytological examination was diagnostic in 12 (54.5%) of 22 patients in Group 1, and in all seven patients of Group 2 (P = 0.063). Telomerase activity was positive in 16 (72.7%) of Group 1 patients, while it was positive in only 1 (14.3%) sample of a lung abscess in Group 2 (P = 0.011). The sensitivity rate of cytological examination when combined with telomerase activity (81.8%) was significantly greater than that of cytological examination alone (54.5%) (P = 0.031). The sensitivity and specificity of telomerase activity were 72.7 and 85.7%, respectively. Telomerase activity had a positive predictive value as 0.94 and negative predictive value as 0.50. Diagnostic accuracy of telomerase activity was 75.8%. Telomerase activity in bronchial lavage is a highly sensitive diagnostic biomarker for malignancy and a potential complementary diagnostic technique to cytological examination in the diagnosis of lung cancer.

The prognostic significance of gastric juice CA 19-9 and CEA levels in gastric carcinoma patients

Aim: The usefulness of gastric juice CA 19-9 and carcinoembryonic antigen (CEA) levels in the diagnosis of gastric carcinoma is controversial. There is only one study related with their prognostic value. In this study the clinical significance of gastric juice CA 19-9 and CEA levels in patients with gastric carcinoma was investigated.Methods: Preoperative serum and gastric juice CA 19-9 and CEA concentrations were measured in 139 patients with gastric carcinoma, 54 patients with benign gastroduodenal disease and as the ‘healthy’ control group 46 patients with inguinal hernia and with no other pathology.Results: In all groups the mean gastric juice levels of CA 19-9 and CEA were significantly higher than the serum levels. The gastric juice CA 19-9 levels were not different between groups. Gastric juice CEA levels of the gastric carcinoma group were significantly higher than those of the benign gastroduodenal disease group (P=0.007) and had a tendency to increase when compared to those of the control group (P=0.064) whereas there was no significant difference between the benign gastroduodenal disease and the control group. The cut-off values of gastric juice CA 19-9 and CEA were 440U/ml and 320ng/ml and the positivity ratios of these markers in gastric carcinoma patients were 16.5 and 27.3%, respectively. There was no significant relationship between the histopathological features and the gastric juice CA 19-9 or CEA positivities. Neither univariate analysis nor the multivariate Cox proportional hazards model analysis showed prognostic value for gastric juice CA 19-9 and CEA positivities.Conclusions: The gastric juice CA 19-9 and CEA levels have no diagnostic and prognostic significance in gastric carcinoma patients.

Trace elements analysis of ascitic fluid in benign and malignant diseases

Objectives: To evaluate differences in ascitic fluid trace element concentrations which might be useful in discrimination between benign and malignant ascites. Design and Methods: The concentrations of copper, zinc, magnesium and iron in ascitic fluid and venous blood in 17 patients were investigated. The relationship between these trace elements and type of disease were examined. Investigations were carried out in a group of 5 males and 5 females aged 54 to 77 yr who had cirrhosis ascites and in a group of 7 females aged 41 to 76 yr with ascites due to gynecologic neoplasms. Results: The mean ascitic fluid and serum concentrations of copper were significantly higher in neoplastic diseases compared to benign disease states (118,43 vs. 97,50, 91,14 vs. 26.90) ( p < 0,05 and p < 0,01 respectively). The zinc levels in ascitic fluid and serum were significantly different between the groups ( p < 0,01). Neoplastic patients had significantly higher ascitic fluid magnesium levels than the benign disease group (2,17 vs. 1,55, p < 0,001). The serum levels of iron were significantly lower in the neoplastic diseases group (92, 28 vs. 255, p < 0, 01). In benign diseases the concentration of zinc in ascitic fluid correlated positively with ascitic fluid copper concentrations. The concentrations of zinc and iron in malignant ascites correlate positively with the magnesium concentrations. Statistically significant negative correlations were found between ascites zinc and magnesium and magnesium and copper in cirrhotic patients and magnesium and copper in malignant diseases. Conclusions: The results showed that zinc, magnesium and iron levels were significantly different between cirrhotic and neoplastic illness. Analysis of serum and ascitic fluid trace element composition may be helpful in identifying and distinguishing the malignant and nonmalignant ascites and provides useful information on processes regulating passage of blood components into the peritoneal cavity.

Clinical significance of tumor markers in the diagnosis of lung cancer

To determine the clinical value of serum TPA, Cyfra 21.1 and NSE in the diagnosis of lung cancer. The serum samples of 136 patients were measured: including 15 adenocarcinomas, 39 squamous cell carcinomas, 8 small-cell lung cancers (SCLC), 34 unclassified lung cancers, and 40 benign pulmonary diseases. Serum TPA and Cyfra 21.1 were detected by ELISA and the normal value was ≤0.9μg/l and ≤3.6μg/l respectively. Serum NSE was detected by radioimmunological method and the normal value was ≤20μg/l. All data were dealed with t and Chi-square test. The level of TPA in each lung cancer group was significantly higher than the normal value except for that in SCLC group. The level of Cyfra 21.1 in adenocarcinoma, squamous cell carcinoma, and unclassified lung cancer groups was significantly higher than the normal value; The level of NSE in SCLC group was significantly higher than the normal value. In the benign pulmonary disease group the level of TPA was significantly higher than the normal value. TPA was sensitive for the diagnosis of lung cancer and the sensitivity was from 69.2% to 87.5%, but the specificity was low (29.3%); the specificity of Cyfra 21.1 was 97.6%, but the sensitivity was low (12.5%-35.9%); the sensitivity (75.0%) and specificity (82.9%) of NSE were high for SCLC. TPA shouldn't be a qualified tumor marker for lung cancer because of low specificity; the specificity of Cyfra 21.1 is higher, but the sensitivity is lower; NSE may be a satisfactory tumor marker for SCLC.

Increased Hypothalamic Dopaminergic Tone Only in Early Parous Women with either Malignant or Benign Breast Tumors

To investigate whether the serum prolactin (PRL) response to a dopamine antagonist was different in nonobese, euthyroid women with malignant or benign breast tumors in comparison with healthy women, considering their age at first full-term pregnancy or their nulliparity. Serum PRL concentrations before and 60, 90, and 120 minutes after oral administration of metoclopramide (10 mg) were studied in 122 nonobese, nonsmoking, euthyroid women: 28 who had invasive breast cancer, stage I or II (group 1), 34 who had benign breast disease (group 2), and 60 who were clinically healthy (group 3). These three main groups were subdivided into early and late parous women (< or = 25 and >25 years, respectively) and nulliparous women, and the menopausal status was also considered. Early parous women with invasive breast cancer (both premenopausal and postmenopausal) and early parous premenopausal women with benign breast disease had significantly higher serum PRL concentrations in response to administration of metoclopramide (P<0.05) and a greater area under the PRL curve (P<0.05) than those observed in early parous healthy women. No other significant differences in the serum PRL response were noted between or within groups. The results of this study suggest the existence of an increased hypothalamic dopaminergic tone in early parous women but not in late parous or nulliparous women with malignant or benign breast tumors in comparison with similar healthy women. This finding may represent an adaptive protective mechanism attempting to prevent persistently increased serum PRL concentrations, a factor that could adversely affect the clinical evolution of the disease.